Pathologist helped catch cross-generational killer
He’s got some brass not wearing a facemask but we can forgive St Mark’s legend Cuthbert Dukes whose bust is on display on Level Five.
The pathologist was instrumental in setting up the world’s first Polyposis Register which monitors and treats successive generations of families carrying a group of cancer carrying genes collectively known as Familial Adenomatous Polyposis (FAP).
St Mark’s pioneering work dates back to the early 1900s when surgeon turned detective Percy Lockhart-Mummery suspected a cross generational killer was stalking his patients.
Lockhart-Mummery had begun noticing a link between polyps found inside the large intestine of some colorectal cancer patients and a high incidence of cancer in their families’ histories.
He began keeping a patient register of people with multiple polyps starting with ‘Patient One,’ a 31 year-old woman whose extended family included eight deaths attributed to bowel cancer. A pattern began to emerge and Lockhart-Mummery enlisted the help of Cuthbert Dukes to take a closer look.
The pair began putting together the missing pieces of the jigsaw and established the Polyposis Registry in 1924. The registry still keeps track of successive generations of families carrying the inherited condition of cancer carrying polyps.
The offspring of a gene carrier has a 50% chance of inheriting the condition themselves and the risk of cancer increases dramatically with age from 7% in 21 year-olds to 93% in the over 50s. In response, St Mark’s surgeons pioneered two procedures still in use today. The second removes the large intestine including the rectum replacing it with a ‘pouch’ created from the small intestine.
Subsequent investigations by Dukes and successive pathologists revealed several types of polyposis.
The registry subsequently gained international renown for its ground-breaking work and most of the current guidelines are thanks to the extensive research and meticulous records that have been kept by staff.
Patients like Brian Cumming remain amazingly optimistic, despite the challenges they face.